Premarin is a brand-name prescription estrogen that treats many health conditions related to low estrogen or conditions that are affected by estrogen. Its active ingredients are conjugated estrogens, a slightly modified version of naturally occurring estrogen, a female hormone that regulates many processes in a woman’s body. Premarin comes in several dosage forms (oral, injectable, and intravaginal). These are not interchangeable and are used for different conditions.
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Premarin overview
BRAND NAMES:
Premarin
Generic Names:
Conjugated estrogens
Uses:
Treats hot flashes, vulvar or vaginal atrophy, and other symptoms of menopause or low estrogen. Prevents osteoporosis after menopause. Premarin also provides palliative treatment for end-stage breast cancer and prostate cancer.
Therapeutic Classes:
Estrogen, endocrine-metabolic agent
Forms:
Tablet, vaginal cream, injectable
How it’s taken:
By mouth, injection, or intravaginally
What is Premarin used for?
Premarin is an estrogen hormone treatment that relieves the symptoms of menopause, prevents postmenopausal osteoporosis, and treats vulvar or vaginal atrophy due to menopause. The FDA has also approved Premarin as a treatment for low estrogen levels and abnormal uterine bleeding. Healthcare professionals also use Premarin as a supportive treatment for people in the last stages of breast cancer or prostate cancer.
What form(s) does Premarin come in
Tablet
0.3 mg
0.45 mg
0.625 mg
0.9 mg
1.25 mg
Vaginal cream
0.625 mg/gm
Injection
25 mg/vial
What are common Premarin doses?
For moderate to severe vasomotor symptoms of menopause: 0.3–1.25 mg given daily OR given in a cycle once daily for 25 days followed by five days off
For the prevention of osteoporosis due to menopause: 0.3–1.25 mg given daily OR given in a cycle once daily for 25 days followed by five days off
For moderate to severe vulvar and vaginal atrophy due to menopause: 0.3–1.25 mg tablet given daily OR given in a cycle once daily for 25 days followed by five days off OR 0.25–2 g of cream applied topically into the vagina once daily for 21 days followed by seven days off
For pain during sexual intercourse due to vulvar or vaginal atrophy: 0.5 g of cream applied topically into the vagina once daily for 21 days, followed by seven days off
For low estrogen due to:
Hypogonadism: 0.3–0.625 mg given in a cycle once daily for three weeks, followed by one week off
Castration or primary ovarian failure: 1.25 mg given in a cycle once daily for three weeks, followed by one week off
For abnormal uterine bleeding: 25 mg intravenous or intramuscular injection that can be repeated if necessary six to 12 hours later
For the palliative treatment of metastatic breast cancer: 10 mg three times daily for three months
For the palliative treatment of advanced androgen-dependent prostate cancer: 1.25 or 2.50 mg three times daily
Find more information about Premarin dosage, forms, and strengths here.
Common Premarin prescriptions
Premarin
100 tablets bottlePremarin
30 tablets bottlePremarin
25mg solution reconstitutedPremarin
0.3mg tabletPremarin
0.45mg tabletPremarin
0.625mg tabletPremarin
0.9mg tabletPremarin
1.25mg tabletPremarin
30gm of 0.625mg/gm tube of cream
How to take Premarin
Take Premarin as directed. The doctor may require you to take this medicine on a cycle (such as three weeks daily dosing followed by one week off this medicine).
Read and follow the Patient Instructions that come with this medicine.
Take this medicine daily without skipping doses, even if you feel better after a few days.
Take this medicine at the same time each day.
How to take Premarin tablets:
Premarin tablets can be taken with or without food.
Swallow Premarin tablets with a glass of water.
If a tablet appears in the stool, contact the prescriber.
Store Premarin tablets at room temperature.
How to administer Premarin vaginal cream:
Attach the applicator to the end of the tube.
Squeeze out enough cream until it hits the mark for the prescribed dose.
Remove the applicator from the tube.
Lie on your back with your knees up.
Insert the applicator gently into the vagina.
Push down the plunger until it’s fully depressed.
Remove the applicator and wash it in warm water and mild soap.
Store Premarin vaginal cream at room temperature.
What to do if you miss a dose of Premarin
Take a dose as soon as possible.
If it’s almost time for the next regular dose, skip the missed dose and take the next dose as scheduled.
Do not take extra medicine to make up for a missed dose.
Premarin contraindications
This medicine is not right for everyone. Do not use it if you have had a severe allergic reaction to estrogens, are pregnant, or have:
Liver disease
Undiagnosed abnormal vaginal bleeding
Breast cancer or a history of breast cancer (except in people being treated for metastatic breast cancer)
Any other cancer that is estrogen-dependent, such as uterine or ovarian cancer
A history of blood clotting problems
A history of heart attack or stroke
Protein C or protein S deficiency
Premarin warnings
Tell any doctor or other healthcare provider who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery, need certain types of medical tests, or if you require prolonged bed rest.
The doctor will need to check on your progress regularly, see that the dose is working, and determine whether you still need to take Premarin. Keep all appointments.
Make sure to tell the prescriber if you have:
Endometriosis
A history of cancer
Asthma
Diabetes
A history of seizures
Heart problems
High blood pressure
High cholesterol or a family history of high cholesterol
Kidney problems
A history of liver problems related to pregnancy or estrogen
Gallbladder problems
High calcium
Migraine headaches
Thyroid problems
Porphyria
Estrogen therapy can cause serious problems, including:
Heart attack
Stroke
Blood clot problems
Breast cancer
Ovarian cancer
Uterine cancer
Benign tumors of the uterus (fibroids)
Gallbladder problems
Liver problems
Dementia
High blood pressure
High blood sugar
It is not safe to take Premarin while pregnant or breastfeeding. Tell the prescriber right away if you become pregnant.
Premarin interactions
To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements being taken, particularly:
Other female hormones
Thyroid hormones
Tell other healthcare providers you are using this medicine before they prescribe new medications.
Premarin side effects
Serious side effects
Immediately contact a doctor or get medical attention if you notice any signs or symptoms of a possible serious side effect, including:
Unusual vaginal bleeding
Sudden or severe headache, numbness or weakness on one side of your body, problems with vision, speech, or walking
New breast lumps, breast discharge
Swelling in your face, hands, ankles, or feet
Seizures
Yellow skin or eyes
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious side effects
Headache
Irregular vaginal bleeding or spotting
Breast pain or tenderness
Abdominal pain
Gas
Weakness
Back pain
Nausea
Depression
Trouble sleeping
Vaginitis
Vaginal burning, itching, or discomfort (vaginal cream)
Sources:
Premarin conjugated estrogens cream prescribing information, DailyMed (NIH National Library of Medicine)
Premarin conjugated estrogens injection prescribing information, DailyMed (NIH National Library of Medicine)
Premarin conjugated estrogens tablet prescribing information, DailyMed (NIH National Library of Medicine)
Premarin drug summary, Prescriber’s Digital Reference (PDR)
Premarin HCP, Pfizer Inc.
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